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Price: $86.95

Paperback 480 pp.
50 photos; 28 figures; 8 tables, 7" x 9"



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Imprint: OUP Canada

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Pursuing Health and Wellness

Healthy Societies, Healthy People, Second Edition

Alexander Segall and Christopher J. Fries

Now in its second edition, Pursuing Health and Wellness looks beyond health as a mere absence of disease to explore the structural and behavioural factors that affect it. Advocating for the creation of healthy societies throughout, the text's three-part organization examines health as a social construct; the social and personal determinants of health and wellness; and the components of our health-care system.

Readership : Pursuing Health and Wellness is a core text for second- and third-year level sociology of health courses taught out of sociology departments as well as some introductory health studies courses taught out of health studies programs that take a sociological approach.


  • "The book does a great job focusing on both good health/well-being (as opposed to just poor health and illness) and social determinants of healthy aging. Also it has a great discussion on measuring health."
    --Steven Prus, Carleton University

  • "I find [the text] refreshing in its orientation to health and wellness. The text gives students a strong background in the theoretical frameworks driving particular types of research. The mix between current and historical examples is helpful for students"
    --Rochelle Tucker, Simon Fraser University

Note: each chapter includes:
- Chapter summary
- Study questions
- Recommended readings
- Recommended websites
- Recommended audiovisual sources
Part One: Understanding Health and Wellness Sociologically
1. Introducing Health Sociology
Introduction: The Mystery of Good Health
Health as a Social Construction
Health Consciousness: Producing Health versus Consuming Health Care
The Origins of Medical Sociology
The Scope of Medical Sociology
From Medical Sociology Toward Health Sociology
Health Sociology in Canada
- The Social Determinants of Health
- Health and Illness Behaviour
- The Health-Care System
2. Applying the Sociological Imagination to Health and Illness
Applying Sociological Paradigms to Theorize Health and Illness
Health and Illness as "Social Roles" - The Structural Functionalist Paradigm
Health and Illness as "Professional Constructs" - The Conflict Paradigm
Health and Illness as "Interpersonal Meanings" - The Symbolic Interactionist Paradigm
Health and Illness as "Gendered Experiences" - The Feminist Paradigm
Health and Illness as "Embodied Cultural Facts" - The Sociology of the Body Paradigm
Health and Illness as "Unfolding Across Time" - The Importance of Adopting an Intersectional Life Course Perspective
3. Measuring the Dimensions of Health
The Meaning and Measurement of Health
Differentiating Personal and Population Health
Adopting a Salutogenic Approach for Understanding the Dimensions of Health
The Meaning of Ill Health (Sickness) and Good Health (Wellness)
- Sickness: The Presence of Disease and the Experience of Illness
- Wellness: More Than the Absence of Disease and Illness
- The Process of Health Status Designation: Separating the Dimensions of Health
Understanding the Difference between Health Inputs and Health Outcomes
Health Status Indicators
- Single-Item Measures: Global Self-Rated Health
- Composite Measures: The Health Utilities Index
Indicators of Ill Health: Limits to the Standard Approach
- Morbidity and Mortality
- Disability and Utilization of Health Services
- What Can We Learn about Health from Disease and Death Rates?
Indicators of Good Health: The Challenge of Measuring Wellness
- Sense of Coherence
- Canadian Index of Wellbeing
- Health Expectancy: Estimating Future Health Status and Quality of Life
The Need for a Mixed-Methods Approach to Measuring Health: Surveys, Statistics, and Stories
- Population Health Surveys: The Canadian Experience
- Health Diary Studies and Illness Narrative Accounts: The Importance of Digging Deeper
Part Two: Exploring the Factors That Shape Health and Wellness
4. Making People Healthy: General Determinants of Health and Wellness
What Makes People Healthy? Two Different Answers
Personal and Structural Health Determinants
The Major Determinants of Population Health: An Overview of the Four Key Factors
- Biology
- Lifestyle Behaviour
- Environment
- Use of Formal Health-Care Services
The Relative Importance of Health Determinants
- Upstream and Downstream Health Determinants: Jason's Story
- Primary and Secondary Determinants: Moving Upstream
- Understanding the Cumulative Effects of Health Determinants: A Life Course Approach
- Estimating the Health Benefits of Major Determinants
The Determinants of Good Health and Ill Health
5. Addressing Sources of Inequality and Health Disparities: Socioeconomic Status
Understanding Social Inequality
Social Determinants of Health Disparities: Income, Occupation, and Education
- Income
- Occupation
- Education
The Social Gradient of Health
Explanations of the Social Gradient in Health
- Materialist and Neo-materialist Explanations
- Cultural Behavioural Explanations
- Psychosocial Explanations
Income Inequality and Population Health: More to the Story
Reducing Social Differences in Health: Is It Possible to Close the Gap?
Toward an Intersectional Theory of Health and Socioeconomic Status across the Life Course
6. Addressing Sources of Inequality and Health Disparities: Gender
Health and Gender
The Importance of Sex- and Gender-Based Analysis in Health Research
Gender Differences in Health
- Women Live Longer Than Men
- The Genders Differ in Major Causes of Death
- Women Are Diagnosed as Suffering from More Ill Health Than Men
- Women Make More Frequent Use of Formal Health Care Than Men
- Gender Differences in the Social Determinants of Health
Explanations of Gender Differences in Health and Illness
- The Role Accumulation Hypothesis
- The Role Strain Hypothesis
- The Social Acceptability Hypothesis
- The Risk-Taking Hypothesis
Toward an Intersectional Theory of Health and Gender across the Life Course
7. Addressing Sources of Inequality and Health Disparities: Ethnicity
Health and Ethnicity
Ethnic Differences in Health
- Aboriginal Peoples Have Poorer Health Outcomes Because of Social Exclusion and Racism
- The Healthy Immigrant Effect Deteriorates over Time
- Ethnic Differences in the Perception and Understanding of Symptoms
- Ethnic Differences in Health-Care Behaviour
- Ethnic Differences in the Social Determinants of Health
Explanations of Ethnic Differences in Health and Illness
- Biological Determinist Explanations
- Cultural Behavioural Explanations
- Socioeconomic Explanations
- Ethnicity, Religion, and Health
Toward an Intersectional Theory of Health and Ethnicity across the Life Course
8. Unravelling the Mystery of Health: An Intersectional Model of Health across the Life Course
Intersectionality and Health Disparities
Lifestyle Behaviours and Health
Individualized Health Promotion
- The Individualization of Health Lifestyles
- Health Lifestyles or Health Behaviours?
Theorizing the Intersectionality of Health
- Health Lifestyles and the Structure-Agency Issue
- Pierre Bourdieu and a Relational Theory of Health Lifestyles
An Intersectional Model of Health and Health Lifestyles across the Life Course
9. Discovering the Hidden Depths of Health Care: Lay Beliefs, Social Support, and Informal Care
The Iceberg of Health Care
Hidden Components of the Health-Care System
- Lay Beliefs about Health Maintenance and Illness Management
- Popular and Professional Health Belief Systems
- Self-Care Beliefs and Behaviour
- Social Support, Helping Networks, and Health
Informal Care and Illness as Embodied Experience: Making Sense of Sickness and Maintaining a Healthy Self-Identity
- A Narrative Account: The Meaning and Management of Pain
- Chronic Illness Work
10. Medicalizing Beings and Bodies: The Link between Population Health and Biomedical Care
The Origins of the Biomedical Model
- Bedside Medicine
- Hospital Medicine
- Laboratory Medicine
Basic Ideas of the Biomedical Model
- Mind-Body Dualism
- Physical Reductionism
- Specific Etiology
- The Machine Metaphor
- Therapeutic Focus on Individualized Regimen and Control
Medical Dominance of the Health-Care System
Medicalizing Beings and Bodies
- Explanations for Medicalization
11. Moving beyond Biomedicine: Medical Pluralism
The Social Construction of Healing: A Sociological Perspective on Medical Pluralism
- The Historical Persistence of Medical Pluralism
- Avoiding the "Stereotypes of Marginality" in Social Studies of Alternative Medicine
- Labelling Alternative Medicine
- Three Streams of Complementary Alternative Medicine Research
Explanations for the Revival of Medical Pluralism
- The Demographic Transition and Population Aging
- Dissatisfaction with Biomedicine
- The Postmodern Condition
- Individualization and Consumerism
Crossing Cultures in Pursuit of Health and Wellness: Choosing Healing Practices
- Medical Consumerism, the Marketing of Ethnicity, and Revival of Medical Pluralism
Integrative Medicine: Prospects for a New Medicine
12. Achieving Healthy Futures
Toward a Sociological Understanding of Healthy Societies and Healthy People
- Studying Health: Alternative Sociological Paradigms
- Developing an Intersectional Model of Health across the Life Course
- Measuring the Dimensions of Health: A Mixed-Methods Approach
Social Determinants of Health: Reflections on What We Have Learned
- Structural and Personal Determinants of Health
- Sources of Social Inequality and Health Disparities: Intersections of Socioeconomic Status, Gender, and Ethnicity
- Adopting a Life Course Perspective on the Pursuit of Health and Wellness
- Life Chances and Health Choices: The Structure-Agency Question
Shared Responsibility for Making Societies and People Healthy
- Personal Responsibility: Informal Care and Health
- Professional Responsibility: Formal Care and Health
- Public Responsibility: The Governance of Health
- Health Policy Initiatives: Lalonde and Beyond
The Ongoing Pursuit of Health and Wellness: Some Unanswered Questions
- How Does the Vision of a Healthy Society Differ from the Reality of Health-Care Reform?
- Is It Possible to Redress Social Inequalities in Health?
- Why Is It So Difficult to Implement Healthy Public Policy?
- Is Wellness Always Good for Your Health?
- What Is Required to Remake the Medicalized Society into a Salutogenic Society

Instructor's Manual:
For each chapter:
- Learning objectives
- Chapter summaries
- Suggestions for lecture topics
- Suggestions for class discussion/debate
- Student activities
- Essay questions
- Suggested readings and websites
PowerPoint slides:
- More than 20 lecture outline slides per chapter
Test Bank:
For each chapter:
- 20-25 multiple choice questions
- 10-15 true-or-false questions
- 5 short answer questions
- 3 essay questions
- Answers and page references
Online Appendix
- Covers research methods in health sociology
Student Study Guide:
- Learning objectives
- Chapter summaries
- Key terms list
For each chapter:
- 5-10 study questions
- 3-5 discussion questions
- 3-5 exploration and debate questions
- 10 additional sources (readings, films, websites)
E-Book (ISBN 9780199014347)

Alexander Segall is a professor emeritus and a senior scholar of sociology in the Faculty of Arts and a research affiliate at the Centre of Aging at the University of Manitoba. In his 40-year career as a health sociologist, his research has focused on the social determinants of health, population health assessment, self-health management, and healthy aging. He was the principal investigator on a longitudinal population health promotion research program at the University of Manitoba titled the Wellness Institute Service Evaluation Research (WISER) Program, whose objective was to better understand the social determinants of population health and the factors that keep Canadians healthy across the life course. Segall has published extensively; his articles have appeared in a wide range of journals, including Social Science and Medicine, Journal of Aging and Health, and the Canadian Journal on Aging. He has also authored several book chapters and co-authored Health and Health Care in Canada with Neena Chappell in 2000.

Christopher J. Fries is an assistant professor of sociology in the Faculty of Arts at the University of Manitoba. His research interests centre on health and lifestyles behaviour, critical public health, social determinants of health, and medical pluralism. A mixed-methods research design specialist, Fries's work, using both qualitative and quantitative data-collection methods, has appeared in Health Sociology Review, Refuge: Canada's Journal on Refugees, Journal of Mixed-Methods Research, and Canadian Ethnic Studies. Fries has also authored several book chapters, written on sociological matters for public consumption (for the Huffington Post and Winnipeg Free Press), and was recently given a Faculty Access Award for providing outstanding service in accommodations on campus for students with disabilities.

Social Determinants of Health - Alan Davidson
Health, Illness, and Medicine in Canada - Juanne Nancarrow Clarke
Health and Society - Edited by James Gillett, Gavin J. Andrews and Mat Savelli
Second Opinion - John Germov and Jennie Hornosty
Making Sense in the Social Sciences - Margot Northey, Lorne Tepperman and Patrizia Albanese
Understanding Health, Health Care, and Health Policy In Canada - Neena L. Chappell and Margaret J. Penning

Special Features

  • Written by experts in the field - both Alexander Segall and Christopher J. Fries draw on years of experience to offer students a comprehensive and authoritative resource.
  • Explicit focus on health and wellness - the only book on the market to do this - rather than defining health as the absence of illness and disease, encourages readers to actively pursue healthy lifestyles.
  • Mixed-methods approach includes both quantitative and qualitative data and research perspectives, offering students a wide-ranging view of the multidimensional nature of health.
  • Intersectional and life course perspectives are integrated throughout to make the text's analysis of the many dimensions of health fully comprehensive.
  • Biography boxes personalize the insights of some of the most renowned scholars of health, medicine, and body studies, offering students in-depth, relevant snapshots of the most important research developments in the field.
  • Topical boxes cover relevant surveys, public awareness campaigns, health articles, and other current events related to health and wellness issues.
New to this Edition
  • New and expanded discussions on key topics including gender based analysis in health research (Ch. 6), Aboriginal health (Ch. 7), income inequality (Ch. 5), and health literacy (Ch. 4).
  • Thoroughly updated with the latest research and data - including research findings drawn from major contemporary Canadian surveys such as the most recent Canadian Longitudinal Study of Aging (CLSA).
  • Additional biography and topical boxes explore such topics as e-health (Ch. 1), the indigenous medicine wheel (Ch. 7), the rise of medical skeptics and conspiracists (Ch. 11), and key health policy initiatives in Canada (Ch. 12).
  • Online appendix covering research methods outlines core considerations in the research process for courses more grounded in scientific methods.